North Midlands NHS Trust maternity services downgraded, further to CQC inspection

University Hospitals of North Midlands NHS Trust (“UHNM”) have had their maternity services downgraded from good to “requires improvement” by the Care Quality Commission (“CQC”).

This is further to an inspection by the CQC in March 2023 and following the service of a Section 29A warning notice on the Trust advising them that their maternity services required ‘significant improvement’.As previously reported when the CQC visited North Midlands NHS Trust in March 2023, they felt that there were insufficient effective systems in place to ensure patients were looked after to the appropriate standard. Staff were also failing to use a prioritisation process to ensure delays in the induction of labour were monitored and managed effectively. The full report into their findings has now been published by the Care Quality Commission.

Following on from the inspection, the safety of the maternity service has also dropped from “requires improvement” to “inadequate”. Areas of concern highlighted by the CQC which have led to the inadequate rating include:

• Midwifery Staffing

Staffing levels did not always match the planned numbers putting the safety of women and birthing people and babies at risk. The Trust confirmed to the CQC that the department was facing a shortfall in maternity staff, as is the picture in many trusts across the country, although attempts were being made to tackle this with recruitment drives and cover from bank and agency staff

• Incidents

Staff were noted to recognise and report both incidents and near misses, but the level of harm was not always recorded correctly when reporting them. Whilst incidents were reported in accordance with policy, there were some occasions where significant harm had occurred with the potential for further complications that had been graded as “No harm” or “Low harm”.

• Environment and Equipment

The service was not always able to provide suitable facilities to meet the needs of women and birthing people or their families. Those waiting to be triaged would be asked to wait alone without the support of their birth partners and would be in waiting areas not visible to staff. Whilst they were waiting, no checks were being carried out by staff which gave rise to potential delays in accessing treatment.

Staff advised the inspection team that they would need to travel to other clinical areas to obtain CTG machines as there was not enough of them. A delay in the monitoring of the fetal heartbeat can lead to any concerning features not being picked up in a timely fashion and therefore risks the safety of babies.

• Assessing and responding to risk

Staff were found to not always identify and act on women and birthing people at risk of deterioration. It was also noted that whilst risk assessments were used to highlight risks, they were not always able to provide treatment within agreed timescales.

• Mandatory training

Whilst mandatory training was provided by UHNM in a range of key skills to staff, at the time of the inspection the completion of such training was falling short of the 95% target.

Given the Section 29 notice issued by the CQC earlier this year UHNM were anticipating the downgrading of their services. They have started the process of change within the Trust, but it is clear there will be a closer focus upon the service to ensure that they are making the necessary improvements and the safety of babies, and their families is prioritised.

Karen Reynolds, Partner within the Clinical Negligence, team has reflected upon the recent findings: “As the CQC continue with their national maternity services inspection programme, it is sadly unsurprising that we find another trust unable to provide a good standard of maternity care.  I have pursued claims against the Trust with regard to poor maternity care and I hope that the Trust will take on board the recommendations of the CQC and implement all necessary changes to improve safety”.

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Our clinical negligence team has a wealth of experience in dealing with the effects of poor maternity care, birth injuries to mother and baby and still birth. If you think that you, or a loved one, may have been affected by negligent medical care during pregnancy or birth whilst under the care of University Hospitals of North Midlands NHS Trust or elsewhere, you are welcome to contact our team to discuss how we can help and support you:

• Karen Reynolds | Partner (Derby/Stoke on Trent/Birmingham/Manchester/Liverpool): 0345 272 5677 or by email to [email protected]
• Siobhan Genever | Director: 0345 030 5774 or 07971 586185 or by email to [email protected]
• Demi Shephard | Trainee Solicitor: 0345 128 7996 or by email at [email protected]
• Ibrahim Mahmood | Legal Assistant: 0345 126 4359 or by email to [email protected]

For further information please get in touch with our Clinical Negligence Team.